a yardstick close to fleeing from med/oncology job to a SNF. HELP!!!

uptoRNin04 · Oct 25, 2006

I am an RN who worked over 20 years in long term care. It was great but, after all that time I went back to school to be an RN because I wanted more. You don't mention how old you are but by reading your post, you are giving up way too much just because you don't like the "dirty" part. A job with the feds is one of the best jobs you can have. You can move anywhere in the country you want without any problem and as you say the benefits are really really good. Also, I know they have a great retirement plan and you can retire really early. I think you may be making a mistake by going to a LTC facility. Believe me, they are not all what they promise either. How long have you worked at this hospital? Do you have anyone there to talk over your concerns with? Find someone to buddy with and share your thoughts. Good Luck.

nightingale, RN · Oct 25, 2006

Skilled Nursing Facilities can be very, very hard work. Ask if you can shadow a Nurse for a couple of days. You will be amazed at how difficult it is to pass meds (including eye drops, nose sprays, and insulin's) with PRNs to 25 patients who may be all over the facility between being in there rooms, visiting PT or OT (do not forget to premed for pain for PT), smoke breaks, visiting family outside on the porch, and several other places.

I loved the elderly but LTC is very challenging work. I really missed the hospital environment when I worked in LTC, almost, exclusively.

The other poster is right, your benefit package is as good as it can get with your federal job.

elthia · Oct 25, 2006

I really need your advises, please!
I work for the veteran's hospital and our unit is not nearly half "oncology" as I thought it would be. We get more of the "med" part of it plus a lot of psych nursing and long term nursing for those denied placement or awaiting placement; some of them have been on our unit for months awaiting for some place to accept them. Most of them are total care and on eve shift, we get 1 aide who is on "light duty" and does nothing but VS. Each nurses have 8-12 pts on their team plus 2 LPNs to split the 24beds we have.
Some of the staff are absolutely great, some not so great, there are some bossy LPNs and great ones as well. I clean up at least twice every shift because more than half of our pts are total care. I hate the cleaning part and some of you will say "well you went into the wrong profession" but I love everything else about nursing that I do except the dirty part. I don't mind running around carrying out orders here and there, or having to call the MD for this and that, talking to a pt to teach or help them calm down when a situation calls for it, but it's the cleaning part. I don't mind doing it once in a while but is it right for a 24bed unit to have an aide who only does VS? For about 3 weeks now, our aide's only job is to sit our confused patients, been there about 2 months now. So we do our own VS while the LPNs pass the meds, RNs do IVs. Our staff meeting doesn't indicate that things are going to get any better. We are not hiring any more aides or LPNs or RNs. "We've got all the staff we need" says our nurse manager.
Pay and benefits are great but somehow it doesn't seem worth all the stress.
I have a job offer from a Skilled Nursing Facility; will be a $5 paycut on weekdays, $11 on weekends, and will get 3 weeks less annual leave.
Somehow I think I'll be able to get pass all the paycut for a less stressful job. But what if it's the same? The SNF DNS who interviewed me says RNs only pass meds and assess 25 pts on their teams, and 2-3 aides on each RNs team do everything else. I'm thinking I wouldn't mind having 25 pts to pass meds to as long as I don't have to clean up. I am so scared that I might be making a big mistake. Plus I know my clinical skills would go down the drain when I move to the SNF but I don't think I can ever get past the cleaning part. I know it's part of helping them get better but I just can't get past it. I would really appreciate all the thoughts and advices.

I took a pay cut when I went from a federal hospital to the private sector, I also have less benefits. I had a nurse pt ratio of 8 pts per nurse (16-30 per RN). Someone started going south the RN had to handle it with the MD until the pt coded, and still have to monitor the chemo and the blood transfusions and everything else. We didn't have resp. therapist, the RN titrated all O2. I suffered through a lot, for the benefits. Then one night I had 2 pt's go bad at the same time. One was coded, the other almost coded. I put in my two weeks notice the next day. Just thinking of that night still makes me feel ill.

What I gained was a safer environment to work in, and the peace of mind knowing that I'm not putting my license on the line just for showing up at work. Also, I now work for a manager that is willing to go to bat for his staff. The nurse/patient ratio is much much better. I also have better resources, if I have a pt going south, I can call the RRT, which brings an ICU nurse with critical care certifications to the floor to assist, respiratory therapist and an intern. The RRT's slogan is "TO PREVENT THE CODE". Which means that after giving report to the RRT, the nurse can tend to the other pt's if needed, so long as she/he remains available to provide more info, i.e. you can leave the RRT w/the pt to check in on your guy who's getting blood, but you can't leave to go to lunch. To me it was worth the trade.

Look at it this way. No matter where you work, if you are working at the bedside, there will always be "dirty work". Even if you work ICU or PACU, there is still contact with bodily fluids/excrement/vomitus. If you don't want that, I would suggest looking for a clinic type position.

If your main concern is that you can't provide a safe care due to staffing, then think of how much that benefit package is really worth compared to the working conditions.

Hoozdo, ADN · Oct 28, 2006

The other poster is right, your benefit package is as good as it can get with your federal job.

Hmmmmmm, I think not. The vacation time is good -- but not good if you can't take any vacation due to understaffing. The pay is not good unless you have a BSN. All 28 of the insurance plans you can pick only cover 50% drug costs of non-generics. I take one drug that costs $1,400 a month - my share, 700 bucks :angryfire Good thing my husband has GOOD health insurance; he is not a healthworker :trout:

badtz143 · Oct 29, 2006

Thank you all for your reply and thoughts.

I am set to start at the SNF on Nov 8th but haven't told my current workplace that I'm leaving. There are 3 things I am sure about right now: 1, I don't want to clean up anymore, 2, I like the benefits and good pay that this fed job gives me, and 3, I really want to gain more clinical skills.

But lately I haven't had to clean much at all and I am starting to get more comfortable at work. But I know things will pick up one day and I"m gonna be really stressed out. I don't want to regret quitting this job, but I also don't want to regret taking the SNF job either.

I just am not sure what to do anymore.

Thank you all again for the thoughts. I will keep you posted on what I decide on doing.

mom2michael, MSN, RN, NP · Oct 31, 2006

The grass is not always greener on the other side.....Is there anyway to swing both jobs until you decide whether or not you'll like SNF?